Brant Inman, MD, MS, of the Duke University Medical Center, Durham, NC, discusses how heat is being used to improve the efficacy of bladder cancer treatments and to envoke stronger immune responses to the cancer at the 2019 Genitourinary Cancers Symposium, held in San Francisco, CA.
Transcript (edited for clarity)
So we’re interested in the use of heat to treat bladder cancer, and we’re evaluating this in several different ways.
It can be used to improve drug delivery. So for non-muscle invasive bladder cancer where we’re using intravesical chemotherapy agents, we can use heat to warm these chemotherapy agents, and it helps deliver them better to the bladder. And that results in better efficacy.
And there are a couple of trials that have been conducted now, Phase 3 trials, of a novel device in Europe that we haven’t reported yet but that are, probably, I think change the field in this respect.
We’re also interested in heat as a way of stimulating an immune response, because heat, like fever, triggers a bunch of things in the body that your body naturally generates as a response to infections. In fact, the first immunotherapies were developed by injecting people with fever-causing bacteria. So we’re using heat, also, to stimulate immunity. And we are presenting some of our data at this meeting on the use of heat in combination with immunotherapies in order to make the immunotherapies work much better. So we have some pre-clinical data from animal models showing that we can get much better immune responses when we combine them with heating of the tumor.
Heating of the tumor also makes the tumor a little bit more hospitable for the immune response because, normally, tumors, especially as they get larger and more aggressive, they become acidic, low in sugar, because the tumor’s eating all the resources. And when the immune system shows up to try and kill the tumor, the environment is very hostile. And when we heat these tumors up, they get improved blood flow, better oxygenation, and it makes an environment that’s better for the immune response.